Recurrent vestibular disturbances and comorbid conditions: Efficacy of a rapid relief of acute vestibular vertigo in the prevention of comorbid disorders

Management of patients with vertigo is based on rapid relief of vertigo, which reduces the risk of comorbid disorders, increases patient adherence to vestibular rehabilitation, and improves quality of life. Many patients with vertigo develop emotional disturbances such as panic and fear, and often require urgent admission to neurology departments. Incorrect management strategies – such as misdiagnosis of stroke and the use of ineffective therapy in the acute phase of dizziness – lead to persistent postural perceptual dizziness, headaches, neck pain, gait instability, and reduced quality of life. Two case reports are presented demonstrating the effectiveness of identifying the true cause of vertigo and providing appropriate treatment. The first case describes a patient with benign paroxysmal positional vertigo (BPPV), which was mistakenly diagnosed as a transient ischemic attack, leading to the development of comorbid disorders and a significant decline in quality of life. Identification of BPPV and associated emotional disorders, followed by effective treatment, resulted in a positive outcome. The second case presents a patient with migraine-associated vertigo (MAV) and comorbid emotional disturbances that significantly impaired quality of life. Educational counseling and training in rapid and effective relief of acute vertigo attacks greatly improved quality of life. In both cases, a fixed combination of cinnarizine and dimenhydrinate was used as pharmacotherapy, which is effective in reducing vertigo and autonomic symptoms across various causes of vertigo. Identification and effective treatment of common causes of vertigo, such as BPPV and MAV, can significantly reduce the severity of dizziness and improve patients’ functional status.

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